Can Patients Weight Out Incontinence Episodes?

Between the early 60s and late 90s the incidence of obesity doubled, leading to a staggering amount of obesity-related health risks such as type 2 diabetes, heart disease, and urinary incontinence.

No one denies the health benefits of weight loss for patients diagnosed with type 2 diabetes and heart disease, but does weight loss really help overweight and obese patients gain more control of their bladders? The answer might depend on the age of the patient.

A randomized trial published in 2009 studied 338 women with a mean age of 53 ± 11 years, a BMI between 25 and 50, and who reported 10 or more urinary incontinence episodes in a week. Participants were placed in either a six-month behavioral weight loss program (intervention group) or a structured four-session weight loss education program (control group).

The study results showed that women who lost just 8% of their body weight reported a 47% decrease in urinary incontinence episodes per week. The decrease in urinary incontinence episodes was mostly related to stress urinary incontinence (SUI) where the intervention group reported a statistically significant decrease of 57.6% compared to 32.7% in the control group (P=0.02, P<0.0001).

What’s more, there was a statistically significant difference (P=0.04) in the percentage of women in the intervention group (41%) reporting at least a 70% decrease in urinary urge incontinence (UUI) episodes per week compared to the control group (29%).

As an added benefit, women in the intervention group were also more satisfied with the change in their incontinence at the end of the study and perceived a greater reduction in the frequency of their urinary incontinence episodes.

With this study and a few others in mind, a new study of women between the ages of 70 and 79 was conducted to determine if the relationship between body composition and incontinence changed with age.

For women over 70, the impact of weight loss on incontinence is mixed

In December 2016, a study published in the Journal of the American Geriatrics Society set out to evaluate the cumulative effects of being overweight on the bladder by looking at the relationship between body composition (BMI and body fat composition) and muscle mass (as measured by grip strength) with the incidence of stress urinary incontinence and urinary urge incontinence. Participants were followed for three years and included 1475 women between the ages of 70-79 when the study commenced.

SUI and UUI were twice as common among women with the highest BMI or greatest proportion of body fat. However, modest fat loss or reduction in BMI (5% in this study), curbed new or persistent SUI (AOR 0.46, 95% CI 0.25-0.85, P=0.01). A decline in grip strength, as a recognized indicator of overall muscle strength, was also associated with higher risk of new or persistent stress incontinence (AOR 1.94, 95% CI 1.23-3.05, P=0.004), which might indicate that maintaining muscle mass could protect older women from the development or progression of SUI as they age.

The news was not so great for participants reporting UUI episodes. For women over 70, a 5% decrease in BMI was not associated with a reduction in the incidence of new or persistent UUI (AOR 0.82, 95% CI 0.55-1.21, P=.31). Also, a decline in grip strength was not associated with increases in the incidence of UUI (AOR 1.12, 95% CI 0.79-1.57, P=0.53).

One of the goals of the study was to provide information to help clinicians talk to their patients about how changing their weight, body composition, and muscle strength could affect their chances of developing incontinence as they age. But older patients with urinary urge incontinence should not lose hope. There are options to help reclaim bladder function in patients suffering from urinary urge incontinence and other symptoms of overactive bladder (OAB) such as urinary urgency and urinary frequency.

Urgent PC is an effective option for virtually all patients with overactive bladder symptoms

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Blog posts written by Urgent PC providers represent that provider's experience and opinions. Cogentix Medical has not tested nor verified the effectiveness of technical or practical recommendations that deviate from the Instructions for Use.